Exam 1 Flashcards

1
Q
  1. Benzodiazepine Prototype and suffix
  2. Benzodiazepine indications
  3. Action
  4. Contra
  5. Adverse effects
  6. Interactions
  7. Antedote
A
  1. Diazepam (“pam” drugs)
  2. anxiety, alcohol withdrawal, seizure control,
  3. Makes GABA more effective
  4. Preggo, drunk, glaucoma, coma, shock, psychosis
  5. hypotension, confusion, dry mouth, constipation, nausea, vomiting, blurred vision, urinary retention
  6. alcohol. Increased effect w/ cimetidine, contraceptives, disulfuram. Decreased effect with theophylline or pepcid
  7. Flumazenil (Romazicon)
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2
Q
  1. Barbituate/Sedative Prototype and suffix:
  2. indications
  3. Action
  4. Contra
  5. Adverse effects
  6. Interactions
  7. which population gets unpredictable on these?
A
  1. Phenobarbital (“cet” and “al”)
  2. anxiety, sedation, seizure, insomnia, pre-anesthesia
  3. cns depressant
  4. preggo, liver, kidney, respiratory distress, porphyria
  5. CNS (means resp dep), dependency, ataxia, nausea, vomit, constipation
  6. anticoagulants, digoxin, tricyclics, corticosteroids, contraceptives, phenytoin
  7. Peds
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3
Q
  1. Hypnotic Prototype
  2. indications
  3. Action
  4. Adverse effects
  5. Name a couple other anxiolytic/hypnotic drugs:
  6. Name the anxiolytic drug that is less addictive, has less side effects, and doesn’t depress CNS:
A
  1. Ambien
  2. insomnia
  3. works on reticular activating system
  4. sleep walking, amnesia
  5. Promethazine (phenergan) and Benadryl
  6. Buspirone (BuSpar)
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4
Q
  1. What is depression a result of?
  2. Name the neurotransmitters dealing with mood?
  3. Recite the 3 ways (generally speaking) antidepressants work:
  4. What are the classifications (4) of antidepressants?
A
  1. a deficiency of one or more neurotransmitters
  2. Dopamine, norepinephrine, and serotonin
  3. Inhibits MAO, blocks reuptake of neurotransmitter, regulation of receptors and breakdown of neurotransmitters. All lead to increased neurotransmitters in the synaptic cleft.
  4. tricyclics, MAOIs, and SSRIs
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5
Q
  1. Prototype tricyclic:
  2. action
  3. Other than depression, what are some indications?
  4. contra:
  5. adverse:
  6. interactions:
  7. Assessment:
A
  1. imipramine (amitriptyline is another)
  2. inhibits reuptake of serotonin and norepinephrine
  3. used in patients w/ sleep disorders, enuresis in kids, chronic pain
  4. recent MI, preggo/lactation, myelography
  5. Sedation
    dry mouth
    constipation
  6. MAOIs, anticoagulatnts
  7. recent suicide attempts, plans, thoughts, sleep, affect and energy
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6
Q
  1. what does MAO do? So what is the action of MAOIs?
  2. What is Mar-Nar-Par?
  3. Indications of MAOIs:
  4. What dietary issue makes it hard for patients on MAOIs?
  5. adverse:
  6. interactions:
A
  1. breaks down neurotransmitters in brain. MAOIs inhibit MAO. Thus no breakdown of neurotransmitters = happy
  2. A combo of 3 MAOIs that work on those who didn’t respond to newer, safer antidepressants (Marplan, Nardil, Parnate). Used for reactive depression.
  3. Treatment of patients with depression who are unresponsive to, or unable to take other antidepression agents. These suck to be on!
  4. Inhibit breakdown of Tyramines leading to hypertensive crisis.
  5. agitation, hyperreflexia, GI issues, weight gain, dry mouth, hepatotoxic
  6. other antidepressants, methyldopa, INSULIN! Doesn’t play well. NPM (no popular meds)
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7
Q
  1. SSRI prototype and benefit of this class:
  2. Action:
  3. Indications:
  4. adverse:
  5. What happens of too much serotonin?
  6. what is the black box warning on SSRIs?
A
  1. Prozac (fluoxetine “ine” and “pram” drugs). Has less adverse effects than other antidepressants
  2. blocks reuptake of serotonin, no effect on norepi.
  3. in addition to depression, PMDD, anxiety, phobias etc.
  4. insomnia, CNS effects, GI, GU, sexual dysfunction
  5. serotonin syndrome: can be fatal. Fever, agitation, tremors, sweating, diarrhea , seizures, coma, dysrhthmia
  6. suicide especially in youth
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8
Q
  1. Name a few misc. antidepressants:
  2. which of these is used for smoking cessation?
  3. What are the benefits of Wellbutrin/Zyban?
  4. Who is it contraindicated for?
A
1. Bupropion (Wellbutrin, Zyban)
Mirtazapine (Remeron) 
Nefazodone (Serzone)
Trazodone (Desyrel)
Venlafaxine (Effexor)
  1. Bupropion (Wellbutrin, Zyban)
  2. no sexual side effects and no weight gain.
  3. seizures
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9
Q
  1. Do psychotherapeutic drugs cure disorders?
  2. What issues are treated with these drugs?
  3. What is another name for antipsychotic drugs?
  4. Most antipsychotic drugs are ………….. ………… ………….. .
  5. Why is poor compliance common with these drugs?
  6. What are the main side effects?
  7. What are extrapyrimidal symptoms and how can you treat?
A
  1. No. they just help to be able to live semi-normal
  2. schizo, mania/bipolar, ADHD/ADD
  3. neuroleptics or tranquilizers
  4. dopamine receptor blockers
  5. because the side effects and stigma.
6. hypotension
anticholinergic effects
sedation
weight gain
sexual side effects
“fogginess” 
extrapyramidal effects (EPS)
  1. pseudoparkinsonism, akathesia (pacing restless), acute dystonia (grimacing, eye rolling), Tardive dyskinesia (dude in video).

Treat with benedryl or benztropine

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10
Q
  1. Prototype ATYPICAL antipsychotics
  2. Indication:
  3. What is the life threatening adverse effect
A
  1. clozaril (clozapine)
  2. schizophrenia who are unresponsive to standard drugs
  3. neuroleptic malignant syndrome (characterized by encephalopathy [anything related to decreased brain function] ).
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11
Q
  1. prototype TYPICAL antipsychotic:
A
  1. Chlorpromazine (thorazine)
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12
Q
  1. prototype bipolar medication
  2. action:
  3. T or F, is it important to monitor Litium levels? Why? What is normal? What else should be assessed?
  4. Adverse:
  5. contra:
  6. Interactions:
A
  1. Lithium
  2. alters sodium transport in nerves and muscle cells, inhibiting dopamine and norepi
  3. T. Can be toxic. Normal = 0.6 - 1.2. Assess urinary output, liver/renal
  4. pregnancy
  5. renal or cv disease, dehydration, Na+ depletion, use of diuretics
  6. hydrochlorthiazide, haloperidol, carbamazepine
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13
Q
  1. Prototype Dopaminergic:
  2. Indication
  3. Action
  4. Adverse:
  5. side effects:
  6. Contra:
  7. Interactions
  8. why does carbidopa help?
A
  1. Levodopa/carbidopa (sinemet)
  2. s/s of parkinsons helping movement be more normal.
  3. increases dopamine in substantia nigra
  4. arrhythmias (most important) anxiety, nervousness, headache, blurred vision
  5. confusion, dysphagia (very bad), grinding of teeth, clumsiness
  6. pregnancy, glaucoma, urinary of GI obstruction, PROSTATIC HYPERPLASIA (BPH)… may need suprapubic catheter.
  7. MAOIs (increases levodopa), B6 (cancels levodopa),
  8. slows metabolism of levodopa
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14
Q
  1. what is parkinsons
  2. progression:
  3. does it cause pain or problems with thinking?
  4. What is the hallmark of Parkinsons?
A
  1. progressive nervous system disease that destroys dopamine secreting cells
2. Ataxia
Bradykinesia
Lack of Coordination 
Rhythmic Tremors 
Rigidity/Weakness
Trouble Maintaining Position or Posture
Difficulty Walking
Drooling and Affected Speech
Mask-like Expressions
  1. no
  2. bradykinesia
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15
Q
  1. What are the 2 anticholinergics for Parkinsons?
A
  1. Benzotropine (congentin) and benedryl
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